Forgiveness Education and Bullying Prevention and Intervention: Benefits for Bullies, Victims and Schools

Over the past 50 years, attitudes toward incidences of bullying in the schools have shifted significantly. Previously, bullying was seen as an expected and normal part of a child\u27s development and school experience. Some even believed bullying wasn\u27t harmful, that it assisted in character-building, and was simply part of growing up (Smith & Brain, 2000, p. 3). In recent decades, however, the negative effects of bullying have been more widely recognized, and there is growing acceptance that experiences of bullying often lead to negative outcomes, such as poor physical and psychological health, for those who are victimized (Due et al., 2005). Many schools are now taking a closer look at the dynamics of the school environment that contribute to bullying behavior, and are beginning to introduce anti-bullying interventions on a system level. Research has shown that bullying interventions are most successful in the school when they are implemented on an individual, class, and whole-school level (Salmivalli, Kaukiainen, & Voeten, 2005). Salmivalli et al. (2005) claimed that when the structure and aims of an intervention within the school are clear, teachers and administrators are able to implement it more faithfully, which results in a greater reduction of bullying activity. There is also growing interest in examining the characteristics of bullies and victims in order to identify which experiences and qualities are associated with increased bullying behavior, and furthermore, use this knowledge to create interventions that effectively reduce bullying incidents in schools. Thus, in addition to focusing on why kids bully, we also need to focus on how we can help kids who bully change their behavior

AGE RELATED CHANGES IN LOWER EXTREMITY COORDINATION PATTERNS IN FEMALE RUNNERS

The aim of this study was to compare the coordination patterns of the lower extremity joints in older and younger females during running. The results of this study show that the older runners have maintained similar movement and coordination patterns to younger runners as a result of years of running experience. The results in this study could provide researchers and clinicians the information necessary to develop shoe wear and orthotic devices to reduce the risk of injury in specific populations

Short-Term Effects of Rhythmic Sensory Stimulation in Alzheimer’s Disease: An Exploratory Pilot Study

This study assessed the effect of stimulating the somatosensory system of Alzheimer’s disease (AD) patients at three stages of their illness with 40 Hz sound. In this AB cross-over study design, 18 participants (6 mild, 6 moderate, 6 severe) each participated in 13 sessions: one intake and 12 treatment. Treatment A consisted of 40 Hz sound stimulation and Treatment B consisted of visual stimulation using DVDs, each provided twice a week over 6 weeks for a total of 6 times per treatment. Outcome measures included: St. Louis University Mental Status Test (SLUMS), Observed Emotion Rating Scale, and behavioral observation by the researcher. Data were submitted to regression analysis for the series of 6 SLUMS scores in treatment A and 6 scores in B with comparison by group. The slopes for the full sample and subgroups in the 40 Hz treatment were all significant beyond alpha = 0.05, while those for the DVD were not. A thematic analysis of qualitative observations supported the statistical findings. 40 Hz treatment appeared to have the strongest impact on persons with mild and moderate AD. Results are promising in terms of a potential new treatment for persons with AD, and further research is needed

Black Womens and Birth Workers Experiences of Disrespect and Abuse in Maternity Care: Findings From a Qualitative Exploratory Research Study in Atlanta, Georgia

Public health research has generated increasingly sophisticated theories and methods for linking the biological to the social, and for understanding how historical and current forms of discrimination, trauma and injustice find expression in health outcomes. Stark racial disparities in maternal mortality and severe maternal morbidity are particularly appropriate for this exploration because women's sexuality and reproduction has always been a crucial battleground for social control of disadvantaged groups, for assertions of biomedical dominance and professional hierarchies, and for humiliation—and selective celebration—of individuals to further promote specific gender and racial ideologies.Yet, simultaneously, women's sexuality and reproduction has also provided the setting for women to assert their personhood, express their community and cultural solidarity, and define and demand their political and social citizenship. Over the last four decades, women of color have built social movements to link this profound understanding of the personal and political meaning of reproduction to the wider struggle for social justice across a broad range of social institutions where racism finds different forms of expression–schools, police and courts, voting rights and political representation, media and social discourse. The recent surge of attention to what advocates, scholars, politicians and journalists now routinely call the "Black maternal health crisis" helps to create an important opportunity for research to link to action, indeed for research to be action.This report is just one step towards recognition of the role of racism in maternal health. It describes findings from an exploratory, qualitative research study of Black women's experiences during pregnancy and childbirth in Atlanta, which was conducted in 2018 in partnership between Black Mamas Matter Alliance (BMMA), the Averting Maternal Death and Disability (AMDD) program of Columbia University Mailman School of Public Health, Center for Black Women's Wellness (CBWW), and other local community-based organizations. This was part of a larger study conducted in New York City in 2017 (Freedman et. al., 2020). Specifically, the study in Atlanta sought to understand Black women's perceptions of the disrespect and abuse they experienced during pregnancy and childbirth. By focusing on disrespect and abuse during childbirth, the study links to a wider global movement that is mobilizing around the concept of respectful maternity care (Armbruster et. al., 2011). It also constitutes initial steps in pursuit of a wider agenda led by BMMA and women of color organizations that seek to transform knowledge and how it is generated, and by doing so, build power and shift culture, bending the arc of history toward social justice (Aina et. al., 2019)

Autistic College Students and COVID-19: Anxiety, Support Needs and Responses by Specialized Programs

Providing resources and support to college students during the COVID-19 global pandemic has produced unique challenges for all students, particularly those with autism. In March 2020, halfway through the spring term, the COVID-19 global pandemic forced most institutions of higher education across the country to move all instruction and support to an online, remote format, including those for students with autism. Colleges and autism support programs are now grappling with how to effectively support students amid a global pandemic. Yet there is little information available about how students’ needs have changed with this new environment. In this exploratory study, 76 college students with autism from across the country answered a series of questions (both Likert scale and open-ended) about their anxieties related to COVID-19 and attending college. The data were analyzed using descriptive statistics and thematic analysis. Results revealed that students are most anxious about getting sick or spreading COVID-19 to others and least anxious about wearing masks and needing to socially distance. This paper also profiles the adjustments made to several college autism support programs (led by the authors) in order to accommodate the changes to college campuses and the impact on student needs. The survey results and recent experiences across programs will inform recommendations for colleges as they build toward more inclusive, supportive campus environments and respond to crises like the pandemic

Multi-dose Oral Ondansetron for Pediatric Gastroenteritis: study Protocol for the multi-DOSE oral ondansetron for pediatric Acute GastroEnteritis (DOSE-AGE) pragmatic randomized controlled trial

BACKGROUND: There are limited treatment options that clinicians can provide to children presenting to emergency departments with vomiting secondary to acute gastroenteritis. Based on evidence of effectiveness and safety, clinicians now routinely administer ondansetron in the emergency department to promote oral rehydration therapy success. However, clinicians are also increasingly providing multiple doses of ondansetron for home use, creating unquantified cost and health system resource use implications without any evidence to support this expanding practice. METHODS/DESIGN: DOSE-AGE is a randomized, placebo-controlled, double-blinded, six-center, pragmatic clinical trial being conducted in six Canadian pediatric emergency departments (EDs). In September 2019 the study began recruiting children aged 6 months to 18 years with a minimum of three episodes of vomiting in the 24 h preceding enrollment,(1:1 allocation via an internet-based, third-party, randomization service) to receive a 48-h supply (i.e., six doses) of ondansetron oral solution or placebo, administered on an as-needed basis. All participants, caregivers and outcome assessors will be blinded to group assignment. Outcome data will be collected by surveys administered to caregivers 24, 48 and 168 h following enrollment. The primary outcome is the development of moderate-to-severe gastroenteritis in the 7 days following the ED visit as measured by a validated clinical score (the Modified Vesikari Scale). Secondary outcomes include duration and frequency of vomiting and diarrhea, proportions of children experiencing unscheduled health care visits and intravenous rehydration, caregiver satisfaction with treatment and safety. A preplanned economic evaluation will be conducted alongside the trial. DISCUSSION: Definitive data are lacking to guide the clinical use of post-ED visit multidose ondansetron in children with acute gastroenteritis. Usage is increasing, despite the absence of supportive evidence. The incumbent additional costs associated with use, and potential side effects such as diarrhea and repeat visits, create an urgent need to evaluate the effect and safety of multiple doses of ondansetron in children focusing on post-emergency department visit and patient-centered outcomes. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03851835. Registered on 22 February 2019

Innovative approaches to investigator-initiated, multicentre paediatric clinical trials in Canada

Data from clinical trials are needed to guide the safe and effective use of medicines in children. Clinical trials are challenging to design and implement in all populations, and children present additional considerations. Several regions including the UK, USA and Europe have established clinical trial infrastructure to capitalise on expertise and promote clinical trials enrolling children. Our objective is to describe the partnerships and operational considerations for the development of paediatric clinical trials infrastructure in Canada. We describe the design and conduct of four emergency room paediatric trials, with four separate sponsors, across four provinces in parallel. Operations discussed include multisite contract development, centralised risk-based data monitoring, ethical review and patient engagement. We conclude with lessons learnt, additional challenges and potential solutions to facilitate drug development for children in Canada

A pragmatic randomized controlled trial of multi-dose oral ondansetron for pediatric gastroenteritis (the DOSE-AGE study): statistical analysis plan.

BACKGROUND: Acute gastroenteritis is a leading cause of emergency department visits and hospitalizations among children in North America. Oral-rehydration therapy is recommended for children with mild-to-moderate dehydration, but children who present with vomiting are frequently offered intravenous rehydration in the emergency department (ED). Recent studies have demonstrated that the anti-emetic ondansetron can reduce vomiting, intravenous rehydration, and hospitalization when administered in the ED to children with dehydration. However, there is little evidence of additional benefit from prescribing ondansetron beyond the initial ED dose. Moreover, repeat dosing may increase the frequency of diarrhea. Despite the lack of evidence and potential adverse side effects, many physicians across North America provide multiple doses of ondansetron to be taken following ED disposition. Thus, the Multi-Dose Oral Ondansetron for Pediatric Gastroenteritis (DOSE-AGE) trial will evaluate the effectiveness of prescribing multiple doses of ondansetron to treat acute gastroenteritis-associated vomiting. This article specifies the statistical analysis plan (SAP) for the DOSE-AGE trial and was submitted before the outcomes of the study were available for analysis. METHODS/DESIGN: The DOSE-AGE study is a phase III, 6-center, placebo-controlled, double-blind, parallel design randomized controlled trial designed to determine whether participants who are prescribed multiple doses of oral ondansetron to administer, as needed, following their ED visit have a lower incidence of experiencing moderate-to-severe gastroenteritis, as measured by the Modified Vesikari Scale score, compared with a placebo. To assess safety, the DOSE-AGE trial will investigate the frequency and maximum number of diarrheal episodes following ED disposition, and the occurrence of palpitations, pre-syncope/syncope, chest pain, arrhythmias, and serious adverse events. For the secondary outcomes, the DOSE-AGE trial will investigate the individual elements of the Modified Vesikari Scale score and caregiver satisfaction with the therapy. DISCUSSION: The DOSE-AGE trial will provide evidence on the effectiveness of multiple doses of oral ondansetron, taken as needed, following an initial ED dose in children with acute gastroenteritis-associated vomiting. The data from the DOSE-AGE trial will be analyzed using this SAP. This will reduce the risk of producing data-driven results and bias in our reported outcomes. The DOSE-AGE study was registered on ClinicalTrials.gov on February 22, 2019. TRIAL REGISTRATION: ClinicalTrials.gov NCT03851835 . Registered on 22 February 2019